Analysis Of TCM Syndrome Types In Rheumatoid Arthritis Complicated With Dyslipidemia

Purpose:To explore the relationship between Rheumatoid arthritis(RA)patients with dyslipidemia,general conditions,laboratory indicators and TCM syndromes,in order to provide more reference for TCM syndrome differentiation and treatment of RA patients with dyslipidemia.Material and method:January-December,2020 were retrospectively analyzed in liaoning university hospital of traditional Chinese medicine rheumatism,82 cases of hospitalized patients with RA combined dyslipidemia,general clinical information collection,TCM syndrome type and TG,TC,HDL-C,LDL-C,Apo A-?,Apo B,the ESR and CRP laboratory indicators.Eighty-two patients were divided into normal ESR group and elevated ESR group,normal CRP group and elevated CRP group.SPSS26.0 statistical software was used to analyze and compare the differences of ESR,CRP and blood lipids in RA patients with dyslipidemia,as well as the differences of TCM syndromes with gender,age,blood lipids,ESR and CRP.Results:1.A total of 82 patients meeting the diagnostic criteria were collected in this study,including15 males and 67 females,with a male-to-female ratio of 1:4.47;The oldest age was 86 years old,the youngest was 30 years old,and the mean age was 61.27±11.315 years old.There were3 cases between 30 and 39,9 cases between 40 and 49,21 cases between 50 and 59,33 cases between 60 and 69,10 cases between 70 and 79,and 6 cases between 80-89.2.Among the 82 patients,TG increased in 32 cases(39%),17.1% in marginal level and 22%in elevated level.Thirty-seven patients(45.1%)had higher TC,including 21.9% with marginal level and 23.1% with elevated TC.HDL-C decreased in 22 patients(26.8%);LDL-C increased in 28 cases(34.1%),21.9% in marginal level and 12.1% in elevated level.14 cases(17.1%)had Apo a-i elevation.Apo B elevation was observed in 21 patients(25.6%).3.The ESR of RA patients with dyslipidemia was positively correlated with TC and LDL-C,but negatively correlated with HDL-C,and the difference was statistically significant(P<0.05),had no statistical significance with TG,Apo A-? and Apo B(P>0.05);CRP was positively correlated with TG and LDL-C,but negatively correlated with HDL-C,and the difference was statistically significant(P<0.05 or P<0.01);There was no significant difference between CRP and TC,Apo A-? and Apo B(P>0.05).Compared with the normal group,LDL-C of the elevated ESR group was higher than that of the normal group,and HDL-C of the elevated ESR group was lower than that of the normal group,the difference was statistically significant(P<0.05),the levels of TG,TC,Apo A-? and Apo B were not significantly different between ESR and ESR groups(P>0.05).Compared with the normal and elevated CRP groups,the LDL-C level of the elevated CRP group was higher than that of the normal group,and the HDL-C level was lower than that of the normal group,the difference was statistically significant(P<0.05),and the levels of TG,TC,Apo A-? and Apo B were not significantly different between CRP and CRP groups(P>0.05).4.The proportion of TCM syndromes in 82 RA patients with dyslipidemia in descending order was: phlegm and blood stasis syndrome(23.2%)>Damp-heat obstruction syndrome(15.9%)>Deficiency of both Qi and Yin(13.4%)>Bi syndrome of cold and dampness(12.2%)>Rheumatism obstruction syndrome(11%)/blood stasis obstruction syndrome(11%)>Liver and kidney deficiency syndrome(7.3%)>The syndrome of deficiency of qi and blood(6%),among which the syndrome of phlegm and blood stasis accounted for the most.5.In terms of TCM syndromes of RA patients with dyslipidemia,TC,TG,HDL-C,ESR were statistically different from other TCM syndromes(P<0.05);There were no significant differences in gender,age,LDL-C,APO A-I,APO B and the distribution of CRP among different TCM syndromes(P>0.05).Conclusion:1.Women with RA complicated with dyslipidemia were more than men.The most common age is 60-69 years old.2.The level of blood lipid in RA patients is related to ESR and CRP during disease activity,that is,LDL-C increases with the increase of disease activity,while HDL-C decreases with the increase of disease activity.3.TCM syndromes of RA patients were correlated with TC,TG,HDL-C and ESR.4.RA patients with phlegm and blood stasis syndrome are more prone to dyslipidemia.